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OBJECTIVE: To evaluate the test performance of 47 biomarkers and ultrasound parameters to predict subsequent delivery of an SGA infant and adverse perinatal outcome in women presenting with suspected preeclampsia.METHODS: In a prospective, multicentre observational study, 47 biomarkers and ultrasound parameters were measured in 397 women presenting with suspected preterm preeclampsia, with the objective of evaluating them as predictors of subsequent delivery of an SGA infant and adverse perinatal outcome. Factor analysis and stepwise logistic regression were performed in two pre-specified groups.RESULTS: In 274 women presenting at 20(+0) to 34(+6) weeks' gestation (Group 1), 96 (35%) delivered an SGA infant CONCLUSIONS: In women presenting with suspected preterm preeclampsia, measurement of PlGF offers a useful adjunct for identifying those at high risk of delivering an SGA infant, allowing appropriate surveillance and timely intervention.

Current means of assessing women presenting with suspected pre-eclampsia using BP and proteinuria are of limited use in predicting need for imminent delivery.We undertook a prospective multicentre study to determine diagnostic accuracy of PlGF5th centile (Triage assay) and other candidate biomarkers in women presenting with suspected pre-eclampsia at 20-35weeks' gestation, in determining need for delivery for pre-eclampsia within 14days. We calculated ROC curves for predictive potential and undertook principal factor analysis to determine additional predictive ability for biomarker combinations.In 287 women enrolled prior to 35weeks, ROC area (0.88, SE 0.03) for PlGF5th centile for pre-eclampsia requiring delivery within 14days was greater than all other commonly utilised tests (systolic and diastolic BP, urate, ALT), either singly (range 0.58-0.68), or in combination (0.69) (p0.001 for all comparisons), and was greater than that of all other biomarkers; addition of 2 other biomarker panels (either procalcitonin, nephrin and BNP; or cystatin and PAPP-A) increased ROC area to 0.90 but these biomarkers had limited predictive ability on their own.In women presenting prior to 35weeks' gestation with suspected pre-eclampsia, low PlGF has a greater ROC area than other commonly utilised tests. Additional biomarkers add only a small increment to the predictive value of a single PlGF measurement.